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Older adults who hoard can be assisted by community-based organizations
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SAN DIEGO — An American Psychiatric Association Annual Meeting workshop confronted the reality that the condition of individuals who hoard often deteriorates as one ages. Mental health providers and social service agencies are most often who manage these vulnerable older adults.
Jack Sherratt , LCSW, is the Director of Project ORE, which is a hoarding initiative that targets older adults in New York City. It is part of the Educational Alliance.
With the publication of DSM-5, hoarding was identified as a distinct classification.
“Even if someone has the readiness, they may not have the focus and skill” to declutter and make their home safe, Sherratt said.
He suggests early on to explore and reveal the motivation and “reason for resistance.”
Sherratt’s program staff go into the home of a person who is hoarding and provide them strategies, and decluttering and decision making skills.
“It’s not about the stuff. You can clear the stuff. You have to attend to the thoughts, feelings, the core beliefs,” he said.
“The number one contributor to success is managing distraction,” he said. The first thing he does is determine how long a person can pay attention.
“If they can pay attention for 15 minutes and you have a 2-hour session, well, you are going to be standing around.”
Sherratt suggested dividing the space into manageable sections and “controlling the visual field, because if I am trying to focus on the piles in front of me and I can see all the other piles around me it is difficult to focus.” He uses sheets to physically cover the sections that are not currently being worked on and also marks off a staging area for sorting and discarding.
Sherratt also said they use a timer and set up 20-minute sessions followed by a break.
The overall treatment timeframe varies from client to client — often from 15 to 18 weeks unless eviction is eminent.
“It takes a really long time,” he said. It is a long-term relationship that his center continues to “monitor and maintain.”
“Success for me, in addition of keeping people in their homes, is that they are safe and that they are in community,” he said. – by Joan-Marie Stiglich, ELS
References:
Sherratt J. It takes a village: Meeting the challenges of severe hoarding in older adults. Presented at: American Psychiatric Association Annual Meeting; May 20-24, 2017; San Diego.
Disclosure: Sherratt reports no relevant financial disclosures. He is an employee of the Education Alliance.